背景:指甲参与表皮下自身免疫性起泡疾病(SEABD)并不常见。虽然这些变化可能是短暂的,永久的变化也可能发生。这项研究探讨了SEABD患者的指甲受累表现及其相关因素。
方法:从2020年3月至2021年3月,我们招募了56名SEABD患者,他们在三级皮肤医院接受检查并检查了他们的指甲变化。我们调查了SEABD亚型和患者正在接受的治疗与指甲异常之间的关联。其他因素包括年龄,性别,自诊断以来的持续时间,粘膜受累的存在,分析了抗bp230和抗bp180IgG抗体的定量水平(在大疱性类天疱疮患者中)。
结果:最常见的指甲异常是起皱,甲状腺溶解症,和onychoschizia。我们观察到在EBA中出现了较低的甲状腺溶解率,MMP中甲根周围大疱的患病率较低,EBA中瘢痕丢失的患病率较高。利妥昔单抗和氨苯砜可有效预防甲胆溶解,泼尼松龙可有效预防甲下血肿。多发性病变更常见于足指,包括大脚趾,可能是因为更多的创伤暴露。
结论:总之,在SEABD和伴随指甲受累的患者中,潜在的疾病控制,适当的治疗,避免创伤可能会有所帮助。
BACKGROUND: Nail involvement in subepidermal autoimmune blistering diseases (SEABD) is not common. Although these changes can be transient, permanent changes can also occur. This
study addresses nail involvement manifestations and their associated factors in patients with SEABD.
METHODS: From March 2020 to March 2021, we enrolled 56 patients with SEABD who were being examined at a tertiary skin hospital and checked their nail changes. We investigated the association between the SEABD subtypes and treatments that patients were receiving and the nail abnormalities. Additional factors including age, gender, duration since diagnosis, presence of mucosal involvement, and anti-bp230 and anti-bp180 IgG antibody quantitative levels (in those patients with bullous pemphigoid) were analyzed.
RESULTS: The most common nail abnormalities were ridging, onycholysis, and onychoschizia. We observed a lower prevalence of onycholysis in EBA, a lower prevalence of periungual bullae in MMP, and a higher prevalence of scarring loss in EBA. Rituximab and dapsone were effective in preventing onycholysis as well as prednisolone in preventing subungual hematoma. Multiple lesions were found to be more common in the foot digits including great toes, probably because of higher exposure to trauma.
CONCLUSIONS: In summary, in patients with SEABD and concomitant nail involvement, the underlying disease control, proper treatment, and avoidance of trauma may be helpful.